Smoking Cessation Intervention Strategies Research Articles

Healthcare providers' knowledge, attitudes and practices on smoking cessation intervention in the Northern Cape.

Clinicians are crucial in encouraging smokers to quit through behavioural or pharmacological smoking cessation interventions. Smokers quit better with professional help. The level of healthcare providers' (HCPs) knowledge, attitudes and counselling skills related to effective smoking cessation support in the study area remains uncertain. The study aimed to determine HCPs' knowledge, attitudes and practices (KAP) on smoking cessation intervention strategies in the Sol Plaatje district, Northern Cape. Sol Plaatje's 13 district municipality clinics, Kimberley, Northern Cape. A descriptive, cross-sectional analytical study involving healthcare workers in the above setting. A total of 165 HCPs, including medical officers, professional nurses, enrolled nurses and assistant-enrolled nurses working in primary healthcare clinics, were invited to participate in the study, with 156 completing the questionnaires. About 53.9% had no knowledge of South African tobacco smoking cessation guidelines, while 87.2% knew the importance of counselling patients about smoking and its impact on quitting. The majority of them did not know the medicines recommended for tobacco treatment in South Africa. About 89.7% expressed that smoking cessation counselling is an important part of their jobs. However, less than half indicated that they make follow-up arrangements for those attempting to quit. The study revealed gaps in KAP regarding smoking cessation among the respondents, necessitating the need for continuing education on the existing smoking cessation guidelines among these HCPs. The results of this study will help to improve smoking cessation intervention knowledge among health providers.

Cost-effectiveness of pharmaceutical smoking cessation intervention in China primary cancer prevention

Objectives: To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention. Methods: Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted. Results: The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER. Conclusion: In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.

Assessment of Smoking Dependence by FAGERSTRŐM Test and its Association with Some Comorbidities and Educational level

Background: Nicotine addiction is the inevitable result for many smokers. Regardless of control and intervention strategies for smoking cessation, it is important to determine the nicotine dependence score for each smoker. Objectives: To assess the nicotine dependence by FAGERSTRŐM Test for nicotine dependence (FTND score) and to find out the association of nicotine dependence with some smoking-related comorbidities and with the level of education. Patients and Methods: This is a cross-sectional study on a total of 200 adult smokers who were attending different departments in Al-Imamain Al-Kadhimain Medical City during the period from April 2019 to October 2019. Demographic data including age, sex and educational level, number of cigarettes/day, number of attempts to quit smoking, as well as comorbidities including hypertension, ischemic heart disease, and malignancies were obtained. Nicotine dependency was assessed by FTND which consists of six items and has a total maximum score of 10. Results: The overall average of FTND among smokers was 5.8 ± 2.81. A low score was found in 12.5% of the participants, moderate score in 33% and high score in 54.5%. FTND score showed a significant positive correlation with the number of cigarette/day (r= 0.758, p< 0.001), age of the smoker (r= 0.457, p<0.005), and duration of smoking (r= 0.536, p< 0.001), while a negative correlation was found with the educational level (r=-0.547, p<0.001). The presence Smoking-related comorbidities, particularly, ischemic heart disease (IHD) and malignancy, was associated with higher FTND scores compared with the absence of these comorbidities (P<0.001). Conclusions: More than one half of smokers studied had a high nicotine dependence score. Nicotine dependence score correlates positively with the number of smoked cigarettes per day, age of the smoker and duration of smoking, and negatively correlated with the educational level.

Predictors of smoking cessation among people living with HIV receiving routine clinical care

ABSTRACTPeople living with HIV (PLWH) have a higher prevalence of smoking and are less likely to quit smoking than the general population. Few studies involving a large sample of PLWH receiving routine care have evaluated factors associated with smoking cessation. This retrospective longitudinal cohort study evaluated factors associated with smoking cessation among PLWH from 2007 to 2018. Of 1,714 PLWH smokers included in the study, 27.6% reported quitting smoking. Suppressed plasma HIV-1 RNA (<200 copies/ml) was significantly associated with an increased likelihood of smoking cessation (HRadjusted = 1.27, 95% CI [1.03, 1.58]); whereas age/10 year increments (HRadjusted = 0.12, 95% CI [0.04, 0.38]), greater length of care at the HIV clinic (HRadjusted = 0.97, 95% CI [0.94, 0.99]), lack of insurance (HRadjusted = 0.77, 95% CI [0.61, 0.99]) or having public insurance (HRadjusted = 0.74, 95% CI [0.55, 0.97)]), current substance use (HRadjusted = 0.66, 95% CI [0.43, 0.97]) and risk of developing alcohol use disorder (HRadjusted = 0.60, 95% CI [0.43, 0.84]) were associated with a reduced likelihood of quitting smoking. These findings underscore the importance of early smoking cessation intervention among PLWH. In addition, targeted smoking cessation intervention strategies are needed for groups at risk for being less likely to quit, including older patients, and those with alcohol and substance use disorders.

P.6.f.003 - Smoking cessation intervention strategies for special population: depressive disorders and pregnancy

Although a relatively small proportion of women who become pregnant continue to smoke cigarettes, no smoking cessation medication has been shown to be effective for this subgroup of smokers. Bupropion, a nonnicotine-based medication, is approved for the promotion of smoking cessation in nonpregnant individuals. We chose to study it in pregnant smokers because, although pregnancy increases nicotine metabolism, it does not affect the metabolism of bupropion.We evaluated the efficacy and safety of sustained-release bupropion for smoking cessation among pregnant women.We conducted a multiple site, placebo-controlled, randomized clinical trial of bupropion for tobacco use among pregnant women (N=129) (clinical trial number NCT02188459). We enrolled women during the second trimester and randomly assigned them to receive 10 weeks of treatment with either bupropion or placebo, accompanied by a total of 6 smoking cessation counseling sessions (4 during treatment and 2 postpartum). The primary outcome was 7-day point prevalence smoking abstinence, confirmed with breath carbon monoxide measurements, at the end of treatment (week 10) and at week 24. Group differences were assessed as a binary abstinence outcome using a repeated measure generalized estimating equations model with a logit link. Prolonged abstinence and smoking rates were secondary outcomes. Safety measures included maternal treatment-related adverse events, gestational age, the rate of overall and spontaneous preterm births and infant birthweight and size for gestational age, head circumference, and 5-minute Apgar scores.There were no significant differences in the safety measures across the treatment arms and bupropion was not efficacious in promoting smoking cessation at the end of treatment (7-day point prevalence quit rates: bupropion, 11.0%; placebo, 18.5%) or week 24 (7-day point prevalence quit rates: bupropion, 9.4%; placebo, 21.5%) (P>.05). African American women and women with a lower severity of nicotine dependence had significantly higher quit rates overall and women with an opioid use disorder who were being treated with opioid agonist therapy had significantly lower quit rates overall, irrespective of the treatment group (all P values <.05).Although bupropion use was not associated with an elevated risk for pregnancy complications when initiated in the second trimester, it did not increase the likelihood of smoking cessation in this cohort of pregnant women. Because smoking is the major preventable source of poor pregnancy outcomes and psychosocial interventions have only modest beneficial effects, additional studies are needed to identify safe and efficacious smoking cessation medications for pregnant women who continue to smoke.

An Analysis of Variables Discriminating Between Quitter and Non-quitter Groups among Thai Alcohol-dependent Smokers

The purpose of this study was to identify such variables. This study used a cross-sectional research design involving 375 alcohol-dependent smokers who had received smoking cessation intervention from health care providers. The participants were selected using the convenience sampling technique, and a multistage random sampling was used to select two hospitals, and the Thailand National Quit-line for involvement in this study. All participants completed five questionnaires: 1) the Processes of Change Questionnaire (PCQ), 2) the Self-efficacy Questionnaire (SEQ), 3) the Decisional Balance Questionnaire (DBQ), 4) the Severity of Alcohol Dependence Questionnaire (SADQ), and 5) the Fragestrom Test for Nicotine Dependence (FTND). The acquired data was analyzed using percentages, means, standard deviations, and discriminant analysis. The major findings of the study were as follows: the variables that could discriminate between the „quitter‟ and “non-quitter”groups among Thai alcohol-dependent smokers, at the 0.05 significance level were process of behavior change, nicotine dependency, self efficacy and decisional balance. Furthermore, alcohol-dependent smokers in the “quitter” group were found to possess lower levels of nicotine dependence, higher score of process of behavior change, higher levels of self efficacy and higher decision-making abilities than those in the non-quitter group. The findings suggested that smoking cessation intervention strategies for Thai alcohol-dependent smokers should target the process of behavior change, nicotine dependence, self efficacy and decisional balance. However, level of alcohol dependence among alcohol dependent smokers was not significantly able to discriminate between quitter and non-quitter groups. Future studies should consider for develop the effective smoking cessation intervention for this population.

Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease

Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (≥65) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, x²=14.06, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

Systematic Review: Smoking Cessation Intervention Strategies for Adults and Adults in Special Populations

While smoking cessation interventions have been shown to work, questions remain about how to increase their efficacy. To examine strategies for effective tobacco treatment in adults and special populations. MEDLINE, Cumulative Index to Nursing and Applied Health (CINAHL), Cochrane Library, Cochrane Clinical Trials Register, Psychological Abstracts, and Sociological Abstracts (1 January 1980 to 10 June 2005). Systematic reviews; randomized, controlled trials; and observational studies. Two reviewers independently abstracted data on study design, population, sample size, treatment, outcomes, and quality. Findings from systematic reviews were summarized and compared with findings from original research published beyond date ranges included in the reviews. Strength of evidence was used to assess the body of evidence. Our review included studies evaluating the efficacy of cessation strategies, such as self-help, counseling, single pharmaceutical agents, combined pharmacotherapies, and pharmacotherapies combined with psychological counseling. Research findings consistent with previous reviews show that self-help strategies alone are ineffective, but counseling and pharmacotherapy used either alone or in combination can improve rates of success with quit attempts. Two studies of self-help materials reported discrepancies across effects. Five studies provided mixed results for counseling interventions. Fourteen studies provided sufficient evidence of the efficacy of single pharmacotherapy, combined pharmacotherapy, and psychological interventions either with or without pharmacotherapy. Few studies focused on ways to reach or treat special populations. Three studies with hospitalized patients had findings consistent with a previous review showing no strong evidence that clinical diagnosis affected the likelihood of quitting. New evidence was insufficient to address the effectiveness of interventions for persons with coexisting psychiatric conditions and substance abuse problems. Previous systematic reviews variably cover the range of issues we addressed. More recent studies do not fill all gaps, especially those for persons with coexisting disease. Although self-help strategies alone marginally affect quit rates, individual and combined pharmacotherapies and counseling either alone or in combination can significantly increase cessation. Using effective smoking treatments is strongly encouraged for all populations, especially those with high and heavy rates of smoking, such as psychiatric and substance abuse populations.

Adolescents’ smoking behavior and its relationships with psychological constructs based on transtheoretical model: A cross-sectional survey

Background: Korean adolescents’ smoking is currently being considered as a crucial factor determining the health status of adolescents and an important public health and social issue. Objectives: The purpose of the study was to test the applicability of the Transtheoretical model to gain an understanding of smoking behavior change. Methods: A total of 706 adolescents who participated in the smoking cessation programs administered by the Korea Quit Smoking Association or Korean Association of Smoking & Health in 2003 were recruited. Four Korean-version questionnaires were used to identify the stages of smoking behavior and psychological attributes: Stage of Smoking Behavior Change Scale, Processes of Change Scale for Smoking, Decision Balance Scale for Smoking, and Self-efficacy Scale to avoid smoking. Results: Korean adolescents’ smoking behavior was differed according to gender. In addition, the findings revealed that behavioral and cognitive processes of change, self-efficacy, and positives differed across the stages of smoking behavior, and that psychological constructs of the transtheoretical model had a statistically significant impact on smoking behavior change. Conclusions: This research could spawn the development of theory-based and empirically supported smoking cessation intervention strategies and programs directed toward adolescents in the health care and nursing areas.

Women's perceptions of support from partners, family members and close friends for smoking cessation during pregnancy--combining quantitative and qualitative findings.

This article reports on data collected as part of a four-phase study initiated to strengthen practice in the field of smoking cessation during pregnancy. It focuses on the perceived support pregnant smokers would receive for quitting smoking and how this support could be effectively used by incorporating the education of partners/family in smoking cessation intervention strategies. Both quantitative and qualitative methods were employed, and data were collected from pregnant smokers through semistructured interviews and self-completed questionnaires. From the questionnaire data, the women reported that they would receive considerable support from their partners if they decided to stop smoking. The interviews, however, revealed that this support was 'potential' rather than 'real' and that the partners mostly made 'token gestures' such as smoking outside. None of the interviewed respondents reported receiving help in educating their partner/family about the risks of active and passive smoking, thus reducing the potential positive role they could play in smoking cessation. Whilst health professionals are aware of the important role the partner/family may play in successful smoking cessation interventions, these significant others are generally not involved. This study highlights the need for consideration to be given to providing opportunities for couples to be fully involved in smoking cessation interventions outside the antenatal environment.

Smoking or Health? International Trends and Marketing of Tobacco and Possible Interventions

This article focuses on the trends in cigarette smoking in both developed and developing countries. There is a change in the smoking patterns from developed to the developing countries due to the shift of emphasis upon marketing of tobacco in the developing countries by the transnational tobacco industry. This is achieved due to the tobacco company's advertising strategies and its impact on the population. The harmful effects of tobacco production and its impact on the environment and health levels in these countries is discussed. Intervention strategies for smoking cessation and the benefits of such interventions is also discussed. This article focuses on these changes from a political economic of illness approach rather than just focusing on individual smokers and holding only them responsible for their healthy or non-healthy conditions.

Characteristics associated with smoking cessation during pregnancy among working class women

Although smoking prevalence among pregnant women is highest among those of lower socio-economic status, the factors associated with cessation in this high risk group are poorly documented. This paper reports on data from a survey of working class women in Nottingham and Coventry, who were interviewed 6 months after having delivered a baby. It compares the characteristics of the 32 women who quit smoking during their pregnancy and were still ex-smokers at the 6 month post-natal point, with 472 women who had continued to smoke during their pregnancy or had returned to smoking in the post-partum period. A logistic regression analysis revealed three variables that were independently associated with long term cessation-having previously quit for more than 1 week, having a non-smoking partner, and believing that the children of smokers are more likely to get infections. Among the most disadvantaged, an understanding of how close social ties and economic circumstances influence smoking behaviour is crucial, if we are to develop more effective smoking cessation intervention strategies for working class women.

Intervention strategies for smoking cessation

Intervention strategies for smoking cessation

Intervention strategies for smoking cessation

The role of oncology nurses concerned with the health effects of cigarette smoking may often be defined as dealing with the morbidity and mortality associated with tobacco use--caring for individuals diagnosed with tobacco-related malignancies. As current treatment methods of many of these malignancies offer little hope of cure, oncology nurses need to diverge from these traditional roles and include a focus on primary prevention activities. An essential component of these activities is a knowledge of smoking cessation education strategies and an understanding of the methods that motivate and assist individuals to quit smoking.

Essential Elements of Self-Help/Minimal Intervention Strategies for Smoking Cessation

Two decades of research suggest that self-help/minimal intervention strategies for smoking cessation may be the preferred means by which smokers stop and can produce success rates approximating those of more formal programs, at lower cost and with greater access to relevant populations. In order to make the best possible use of these self-help/minimal intervention approaches, the National Cancer Institute (NCI) supported a series of randomized, controlled intervention trials and, in June of 1988, convened an Expert Advisory Panel to address the question "What are the essential elements of self-help/minimal intervention strategies for smoking cessation?". The panel's recommendations were that: (1) Intervention efforts should focus on increasing smokers' motivations to make serious quit attempts; (2) Delivery of programs be broadened to include all smokers; (3) Programs be targeted to stages of cessation and specific populations; (4) All programs include (a) elements focused on health and social consequences of smoking, and (b) strategies and exercises aimed at quitting, maintenance of nonsmoking, relapse prevention, and recycling; (5) Materials and programs be made widely available rather than "fine tuning" existing programs or developing new ones; and (6) Programs make use of specific adjunctive strategies. In this way, a reacceleration of the decline in smoking prevalence may be realized in the 1990s and significantly contribute to the NCI's Year 2000 goals and the Surgeon General's aim of a smoke-free society.